Nancy Walle, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

102329 Issued in CA

Practice address

4962 Fidler Ave
Lakewood, CA 90712-2702

Phone

(562) 658-7280

NPI assigned

Jul 13, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1982959110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4962 FIDLER AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122702",
            "telephone_number": "562-658-7280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4962 FIDLER AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122702",
            "telephone_number": "562-658-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLE",
        "first_name": "NANCY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "70949",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirankumar Vyas, M.D.
• Carolyn Wahby
• Walgreen Co
• Walgreen Co
• David Walker
• Walmart Inc.
• Walmart, Inc.
• Lisa Christine Walsh
• Debby Szu Ti Wang, RD
• Victoria Wang

• Marriage & Family Therapist in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.